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Understanding atrial fibrillation and stroke risk

Understanding atrial fibrillation and stroke risk
by N. A. Mark Estes, III, M.D.

(NAPS)-There's an alarming gap in knowledge about a common heart condition called atrial fibrillation, or AFib. By closing the gap and arming people with what they need to know, we could prevent disabling-and even deadly-strokes; perhaps thousands of strokes each year.
Work recently done at the American Heart Association/American Stroke Association to identify gaps in AFib knowledge and treatment suggests that about half of the estimated 2.7 million Americans who have AFib have not been properly educated about their stroke risk.
The gap? We know that people who have AFib are at higher risk of stroke than people who do not have the condition, yet this information (and resulting proven prevention) isn't trickling to the people who need it most.
What AFib Is
AFib is an irregular heart rhythm that occurs when the heart's two upper chambers beat erratically, causing the chambers to pump blood rapidly, unevenly and inefficiently. Blood can pool and clot in the chambers, increasing the risk of stroke. It's associated with a fivefold increased risk of stroke and a greater likelihood that the stroke will lead to significant disability-even death.
Identifying Challenges
A survey by Synovate, Inc. for the American Heart Association found that 90 percent of patients get AFib information from their doctors.
Of the AFib patients surveyed, half thought they were at risk for stroke; 25 percent claimed they were not at risk; and the rest didn't know. The survey also found only two-thirds of patients recalled that their health care provider talked with them about their elevated stroke risk. Among those who talked with their doctors, 21 percent said they were told they have no stroke risk.
Connecting People and Information
There are several proven ways to reduce the AFib-associated stroke risk. A healthy lifestyle and maintaining an ideal body weight through exercise and diet can prevent high blood pressure and diabetes that predispose an individual to AFib. For individuals who already have AFib, new and effective medications can thin the blood to prevent the clotting associated with stroke.
Despite the substantial benefits that come from taking these medications, many people don't receive or don't take them. One of the hurdles could be that blood thinners have an undeserved reputation as problematic. It's true that one popular blood thinner, called warfarin, requires monitoring to adjust the dosing; newer medications, however, don't. In addition, some physicians and patients tend to overestimate the risk of bleeding complications from these medications.
Your Lifesaving Assignment
If you have AFib, make an appointment with your doctor's office. With today's health care system, you might have the bulk of your AFib conversation with your doctor's nurse practitioner or physician assistant. These people are often charged with taking more time with patients to answer questions and educate.
Learn all you can about the condition. You'll find credible and extensive AFib information from the American Heart Association/American Stroke Association at
The solution to closing this gap is simple communication. We have to start talking about AFib and stroke. At a time when the economy is in turmoil and funding is scarce, talking doesn't cost a dime.

Dr. Estes is a professor of medicine, Tufts University School of Medicine and Director, New England Cardiac Arrhythmia Center, Tufts Medical Center, Boston.

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